Provider Demographics
NPI:1679741920
Name:KUSSEL & ASSOCIATES INC.
Entity type:Organization
Organization Name:KUSSEL & ASSOCIATES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:O
Authorized Official - Last Name:KUSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-797-5007
Mailing Address - Street 1:2378 SUNSET POINT RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765
Mailing Address - Country:US
Mailing Address - Phone:727-797-5007
Mailing Address - Fax:727-725-9737
Practice Address - Street 1:2378 SUNSET POINT RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765
Practice Address - Country:US
Practice Address - Phone:727-797-5007
Practice Address - Fax:727-725-9737
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KUSSEL & ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-20
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2632213E00000X
FLPO2632213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390383400Medicaid
FLU65770Medicare UPIN
FL390383400Medicaid